Effects and tolerability of exercise therapy modality on cardiorespiratory fitness in lung cancer: a randomized controlled trial.

Autor: Scott JM; Memorial Sloan-Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Thomas SM; Duke University Medical Center, Durham, NC, USA., Herndon JE 2nd; Duke University Medical Center, Durham, NC, USA., Douglas PS; Duke University Medical Center, Durham, NC, USA., Yu AF; Memorial Sloan-Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Rusch V; Memorial Sloan-Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Huang J; Memorial Sloan-Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Capaci C; Memorial Sloan-Kettering Cancer Center, New York, NY, USA., Harrison JN; Memorial Sloan-Kettering Cancer Center, New York, NY, USA., Stoeckel KJ; Memorial Sloan-Kettering Cancer Center, New York, NY, USA., Nilsen T; Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway., Edvardsen E; Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway., Michalski MG; Memorial Sloan-Kettering Cancer Center, New York, NY, USA., Eves ND; University of British Columbia, Kelowna, BC, Canada., Jones LW; Memorial Sloan-Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA.
Jazyk: angličtina
Zdroj: Journal of cachexia, sarcopenia and muscle [J Cachexia Sarcopenia Muscle] 2021 Dec; Vol. 12 (6), pp. 1456-1465. Date of Electronic Publication: 2021 Oct 17.
DOI: 10.1002/jcsm.12828
Abstrakt: Background: Poor cardiorespiratory fitness (CRF) is a cardinal feature of post-treatment primary lung cancer. The most effective exercise therapy regimen to improve CRF has not been determined.
Methods: In this parallel-group factorial randomized controlled trial, lung cancer survivors with poor CRF (below age-sex sedentary values) were randomly allocated to receive 48 consecutive supervised sessions thrice weekly of (i) aerobic training (AT)-cycle ergometry at 55% to >95% of peak oxygen consumption (VO 2 peak); (ii) resistance training (RT)-lower and upper extremity exercises at 50-85% of maximal strength; (iii) combination training (CT)-AT plus RT; or (iv) stretching attention control (AC) for 16 weeks. The primary endpoint was change in CRF (VO 2 peak, mL O 2 ·kg -1 ·min -1 ). Secondary endpoints were body composition, muscle strength, patient-reported outcomes, tolerability (relative dose intensity of exercise), and safety. Analysis of covariance determined change in primary and secondary endpoints from baseline to post-intervention (Week 17) with adjustment for baseline values of the endpoint and other relevant clinical covariates.
Results: Ninety patients (65 ± 9 years; 66% female) were randomized (AT, n = 24; RT, n = 23; CT, n = 20; and AC, n = 23) of the planned n = 160. No serious adverse events were observed. For the overall cohort, the lost-to-follow-up rate was 10%. Mean attendance was ≥75% in all groups. In intention-to-treat analysis, VO 2 peak increased 1.1 mL O 2 ·kg -1 ·min -1 [95% confidence interval (CI): 0.0, 2.2, P = 0.04] and 1.4 mL O 2 ·kg -1 ·min -1 (95% CI: 0.2, 2.5, P = 0.02) in AT and CT, respectively, compared with AC. There was no difference in VO 2 peak change between RT and AC (-0.1 mL O 2 ·kg -1 ·min -1 , 95% CI: -1.2, 1.0, P = 0.88). Favourable improvements in maximal strength and body composition were observed in RT and CT groups compared with AT and AC groups (Ps < 0.05). No between-group changes were observed for any patient-reported outcomes. Relative dose intensity of exercise was lower in RT and CT compared with AT (Ps < 0.05).
Conclusions: In the context of a smaller than planned sample size, AT and CT significantly improved VO 2 peak in lung cancer survivors; however, the tolerability-to-benefit ratio was superior for AT and hence may be the preferred modality to target impaired CRF in post-treatment lung cancer survivors.
(© 2021 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.)
Databáze: MEDLINE
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